EFTA01387278.pdf

One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar 3A. Individual Details (for all p flies) Individual's Name: Wallace, Daphne - Date of Birth Country of Residence' USVI Country of Otizensh 0 USV Has client rescleo ou:sioe of luSrher country of Address of primary United States nationality for 5 years or O yes .i. No residence- more? Professon, Occupation: Finance Tax ;D SSN Current Employer: Southern Trust Company Inc Position/Title/Rank: controller Address of employer: 6100 Red Hook Quarter St Thomas United Sates 00802 Does the person work as senior executive of a DB-recognized regulated entity in he financial Industry? or an entity listed on a OB-recognised exchange? (Not Oyes tri No pplicable for operating entities wr Is the individual a Politically Exposed Person (F£P)?(If Yes, describe) O Yes Lali No To the best of your knowledge, lathe individual related to an employee of the DB DFamily O Friendship g None groupWif Family or Friendship, describe ) To the best of your knowledge, is the Individual party to a non-banking relationship with Deutsche Bank (e.g., external legal counsel, client referral ❑O Yes 10 No source, supplier of goods or services)7(if Yes,describe ) If applicable. indicate which bank officers have met Indicate where and when the client meetings) took place the person. Client Client Place Bank Officer Name(s) Bank Office Private Other Location (soecify! Dare of Business Domicile D • O • O O D O O L....iWealth Derails for this individual are not (pled ri because they are :he same as for :he following person. 38. Wealth Details (Only for parties reowr ng source of wea :h oesc-pcion as tad ceed in Section 2) Nature of the Individual's Business: Primary Country of source of wealth/source of Funds? Primary rdustry of source of Wealth/Source of Funds? Summarize Source of Wealth: O Budness Owner O Salary/Earnings • Investment LI Inheritance/Offs O Other: CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0089539 CONFIDENTIAL SDNY GM_00235723 EFTA01387278